中国中西医结合急救杂志
中國中西醫結閤急救雜誌
중국중서의결합급구잡지
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2015年
5期
496-498
,共3页
俞志刚%杨婕%陈燕琼%方邦江
俞誌剛%楊婕%陳燕瓊%方邦江
유지강%양첩%진연경%방방강
不同剂量%参附注射液%充血性心力衰竭,难治性
不同劑量%參附註射液%充血性心力衰竭,難治性
불동제량%삼부주사액%충혈성심력쇠갈,난치성
Different dosages%Shenfu injection%Refractory congestive heart failure
目的 探讨不同剂量参附注射液治疗老年难治性慢性充血性心力衰竭(CHF)的临床疗效.方法 采用前瞻性研究方法,选择上海中医药大学附属龙华医院收治的360例CHF患者,按随机数字表法分为参附低、中、高剂量组.3组患者西医常规治疗方法相同,在此基础上,参附低、中、高剂量组分别加用60、80、100 mL/d的参附注射液,均每日1次,10 d为1个疗程.治疗结束后观察3组患者的临床疗效和左室舒张期末内径(LVEDD)、左室射血分数(LVEF)、每搏量(SV)、心排血量(CO)、心排血指数(CI)以及血中B型钠尿肽(BNP)水平的变化.结果 参附中剂量组患者总有效率明显高于低剂量和高剂量组〔82.5%(99/120)比54.2%(65/120)、60.0%(72/120),均P<0.05〕;参附高剂量组有15例(12.5%)患者出现了血压增高,而低剂量和中剂量组未出现血压增高的病例;3组均未见心律失常、肝功能异常、心肌酶谱异常等不良反应情况的发生.3组治疗后LVEDD、BNP均较治疗前降低,LVEF、SV、CO、CI均较治疗前升高,但上述指标的变化均以参附中剂量组更显著〔LVEDD(mm):46.1±6.3比58.3±4.4,LVEF:0.561±0.056比0.324±0.044,SV(mL):58.1±6.3比35.7±5.4,CO(L/min):5.78±0.60 比 4.21±0.78,CI(mL·s-1·m-2):81.85±7.33 比 53.01±9.00,BNP(ng/L):355.4±76.6比3263.2±65.7,均P<0.05〕.结论 参附注射液用于治疗难治性CHF时以80 mL/d剂量的临床疗效最佳,不良反应发生率较低.
目的 探討不同劑量參附註射液治療老年難治性慢性充血性心力衰竭(CHF)的臨床療效.方法 採用前瞻性研究方法,選擇上海中醫藥大學附屬龍華醫院收治的360例CHF患者,按隨機數字錶法分為參附低、中、高劑量組.3組患者西醫常規治療方法相同,在此基礎上,參附低、中、高劑量組分彆加用60、80、100 mL/d的參附註射液,均每日1次,10 d為1箇療程.治療結束後觀察3組患者的臨床療效和左室舒張期末內徑(LVEDD)、左室射血分數(LVEF)、每搏量(SV)、心排血量(CO)、心排血指數(CI)以及血中B型鈉尿肽(BNP)水平的變化.結果 參附中劑量組患者總有效率明顯高于低劑量和高劑量組〔82.5%(99/120)比54.2%(65/120)、60.0%(72/120),均P<0.05〕;參附高劑量組有15例(12.5%)患者齣現瞭血壓增高,而低劑量和中劑量組未齣現血壓增高的病例;3組均未見心律失常、肝功能異常、心肌酶譜異常等不良反應情況的髮生.3組治療後LVEDD、BNP均較治療前降低,LVEF、SV、CO、CI均較治療前升高,但上述指標的變化均以參附中劑量組更顯著〔LVEDD(mm):46.1±6.3比58.3±4.4,LVEF:0.561±0.056比0.324±0.044,SV(mL):58.1±6.3比35.7±5.4,CO(L/min):5.78±0.60 比 4.21±0.78,CI(mL·s-1·m-2):81.85±7.33 比 53.01±9.00,BNP(ng/L):355.4±76.6比3263.2±65.7,均P<0.05〕.結論 參附註射液用于治療難治性CHF時以80 mL/d劑量的臨床療效最佳,不良反應髮生率較低.
목적 탐토불동제량삼부주사액치료노년난치성만성충혈성심력쇠갈(CHF)적림상료효.방법 채용전첨성연구방법,선택상해중의약대학부속룡화의원수치적360례CHF환자,안수궤수자표법분위삼부저、중、고제량조.3조환자서의상규치료방법상동,재차기출상,삼부저、중、고제량조분별가용60、80、100 mL/d적삼부주사액,균매일1차,10 d위1개료정.치료결속후관찰3조환자적림상료효화좌실서장기말내경(LVEDD)、좌실사혈분수(LVEF)、매박량(SV)、심배혈량(CO)、심배혈지수(CI)이급혈중B형납뇨태(BNP)수평적변화.결과 삼부중제량조환자총유효솔명현고우저제량화고제량조〔82.5%(99/120)비54.2%(65/120)、60.0%(72/120),균P<0.05〕;삼부고제량조유15례(12.5%)환자출현료혈압증고,이저제량화중제량조미출현혈압증고적병례;3조균미견심률실상、간공능이상、심기매보이상등불량반응정황적발생.3조치료후LVEDD、BNP균교치료전강저,LVEF、SV、CO、CI균교치료전승고,단상술지표적변화균이삼부중제량조경현저〔LVEDD(mm):46.1±6.3비58.3±4.4,LVEF:0.561±0.056비0.324±0.044,SV(mL):58.1±6.3비35.7±5.4,CO(L/min):5.78±0.60 비 4.21±0.78,CI(mL·s-1·m-2):81.85±7.33 비 53.01±9.00,BNP(ng/L):355.4±76.6비3263.2±65.7,균P<0.05〕.결론 삼부주사액용우치료난치성CHF시이80 mL/d제량적림상료효최가,불량반응발생솔교저.
Objective To investigate the clinical effects of different dosages of Shenfu injection for treatment of elderly patients with refractory chronic congestive heart failure (CHF).Methods A prospective study was conducted, 360 patients with CHF from Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine were enrolled, and they were randomly divided into low dose, middle dose and high dose Shenfu injection groups. In the three groups, the patients received the same conventional medicine therapy, and additionally they were treated by low, medium and high dose Shenfu injection (60, 80, 100 mL/d, respectively), once a day. The therapeutic course was 10 days in the three groups. After treatment, the clinic therapeutic effect, left ventricular diastolic end diameter (LVEDD), left ventricular ejection fraction (LVEF), stroke volume (SV), cardiac output (CO), cardiac index (CI) and plasma B type natriuretic peptide (BNP) were observed in the three groups.Results The total therapeutic effective rate in middle dose Shenfu injection group was significantly higher than that in low dose and high dose Shenfu injection groups [82.5% (99/120) vs. 54.2% (65/120), 60.0% (72/120), bothP < 0.05]. In high dose Shenfu injection group, increase of blood pressure occurred in 15 cases (12.5%), but no such phenomenon appeared in low and middle dose Shenfu injection groups. In the three groups, no cardiac arrhythmia, liver function abnormality, myocardial enzymogram abnormality, etc. adverse reactions occurred. Compared with those before treatment, after treatment in three groups the LVEDD and BNP were significantly decreased, while LVEF, SV, CO and CI were markedly increased. The changes of above index in middle dose Shenfu injection group were more significant [LVEDD (mm): 46.1±6.3 vs. 58.3±4.4; LVEF: 0.561±0.056 vs. 0.324±0.044, SV (mL): 58.1±6.3 vs. 35.7±5.4, CO (L/min): 5.78±0.60 vs. 4.21±0.78, CI (mL·s-1·m-2): 81.85±7.33 vs. 53.01±9.00, BNP (ng/L): 355.4±76.6 vs. 3 263.2±65.7, allP < 0.05]. Conclusion Shenfu injection 80 mL/d is the best effective dosage for treatment of elderly patients with refractory CHF and its incidence of adverse events is low.
